Caregivers help ill veterans stay at home

Monday

Jun 2, 2014 at 12:01 AMJun 2, 2014 at 9:01 AM

A year ago, Gene Vinings landed in the Chillicothe VA Medical Center for seven weeks after tripping over a foot stool and breaking several ribs in a fall. A hospital doctor and a social worker wanted to place Vinings, a World War II veteran, in a nursing home because of his declining health. But that prospect sent Vinings, then 89, into a tailspin of depression.

Encarnacion Pyle, The Columbus Dispatch

A year ago, Gene Vinings landed in the Chillicothe VA Medical Center for seven weeks after tripping over a foot stool and breaking several ribs in a fall.

A hospital doctor and a social worker wanted to place Vinings, a World War II veteran, in a nursing home because of his declining health.

But that prospect sent Vinings, then 89, into a tailspin of depression. His family worried that his condition would deteriorate further if he wasn’t allowed to return to his Chillicothe home.

“I didn’t like being in the hospital, and I’d rather die than go into a nursing home,” Vinings said.

To spare him more trauma, U.S. Department of Veterans Affairs officials enrolled him in a new program that gives veterans with serious medical conditions at risk of being put into a nursing home a monthly budget to hire professional caregivers, family members or friends to help meet their needs.

Nationwide, about 7.8 million veterans are enrolled in the VA’s health-care system.

In addition to the aging population who served in World War II, Korea and Vietnam, the number of young, severely injured veterans returning from conflicts in Iraq and Afghanistan and needing support continues to rise.

Two years ago, the Chillicothe VA Medical Center partnered with the Area Agency on Aging in Ross County to create the state’s only home-based program just for veterans.

The program has become the nation’s largest, helping 79 veterans in 10 southern Ohio counties, including Fayette, Pickaway and Ross. Forty-five other veterans are on a waiting list.

Enrollees get more choices and have more control over their care, said Keshia King, who oversees the program for the Chillicothe VA.

“Veterans can get the services they need, when and how they want it, in their own homes,” King said. “That improves their physical and mental health and saves money.”

Advocates would like to see a program in Columbus; local VA officials said they’re waiting to see how the Chillicothe program works out.

The other half of the venture is “pretty much ready to go,” said Diana Kubovcik, client-services director of the Central Ohio Area Agency on Aging.

Kubovcik said she thinks local VA officials are worried about how to pay for the program. The national VA office provides funding for two years, and then each local VA medical center picks up the cost.

King said the Chillicothe program is operating on a $1.5 million budget. Officials have committed to keeping the program going even after the federal funds start to phase out next year.

A typical VA nursing home can cost as much as $232,000 annually for veterans with the most needs, she said. But the cost of the home-based program tops out at a much lower price: $39,612 a year.

On average, a program participant receives 33 hours of care a week, King said, and the median budget is $1,957 a month.

In addition to paying for home help, the money may be used to buy grab bars and other items that allow veterans to live at home. Some of the money must be set aside for emergencies.

Satisfaction with the program has been high, said Vicky Abdella, a nurse and director of community services for the Area Agency on Aging in Ross County.

Ninety percent of the veterans enrolled in the Chillicothe program said it allowed them to live independently, while 74 percent said it helped them improve their health and quality of life, Abdella said.

Bette Davis, 88, of Kingston in Ross County, was in and out of the hospital two years ago with heart trouble caused by stress.

Unable to care for her ailing husband, Dwight, 92, Mrs. Davis hired a part-time caregiver, but the expense was quickly depleting the couple’s retirement money. Mr. Davis has Alzheimer’s disease and macular degeneration.

Last year, Mr. Davis was admitted to a nursing home after a blood infection nearly took his life. After he was discharged, a social worker referred the couple to the VA home-based program, and Mr. Davis, who oversaw supplies loaded onto airplanes as a staff sergeant in the Army during World War II, has gotten better.

He now receives 51 hours of personal care a week, paid for by the VA.

“Life has blessed us,” Mrs. Davis said. “This program from the VA is an added measure to what God has already given us.”

Rinehart, meanwhile, has two personal-care assistants to help him with getting dressed, fixing meals and taking medications.

The women also do laundry and light house cleaning and are planting flowers and a garden so Vinings can eat fresh vegetables.

They take Vinings to doctor appointments and to see family and friends. And they bring their children to visit Vinings — to show him how much he is loved, they said.

“He’s pretty much in charge, and we do whatever he needs,” said Courtney Rinehart, who works for Vinings every weekday morning. “You’re the boss man, aren’t you, Gene?”

Vinings has lived alone since his wife of 50 years, Bonagene, died of lung cancer 18 years ago. A professional surveyor, he retired last year, just before his 90th birthday.

When Rinehart isn’t busy with chores, she likes to engage Vinings in intense debates about current events, politics and their favorite topic: military history.

A former gun mechanic in the Air Force, Vinings likes to talk about how he was in China when the United States dropped two atomic bombs on Japan in August 1945.

As a Christmas gift, Rinehart gave Vinings a photo canvas of the USS Nashville, which was damaged by a kamikaze attack during his war. Vinings was one of 1,800 troop members who returned to the United States aboard the Brooklyn-class light cruiser after it was repaired.

Rinehart is “different from most girls,” Vinings said. “She’s not into dresses or dances. She likes the kind of things I do. I think that’s why we’ve clicked so well.”